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Contact Information

KETAMINE WELLNESS CENTERS S L C
6087 S REDWOOD RD STE B
TAYLORSVILLE, UT84123-6854
 Phone: 855-538-3555
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for KETAMINE WELLNESS CENTERS S L C · (Female)

NPI Number 1194491423
Status Active
Credentials
Entity Individual
Enumeration date 08/17/2021
Last updated 07/28/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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